Semin intervent Radiol 2018; 35(01): 035-040
DOI: 10.1055/s-0038-1636519
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Pelvic Congestion Syndrome: Systematic Review of Treatment Success

Candace L. Brown
1  Diagnostic and Interventional Radiology, Advanced Radiology Services, Grand Rapids, Michigan
Magda Rizer
2  Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts
Ryan Alexander
3  Department of Interventional Radiology, Massachusetts General Hospital, Boston, Massachusetts
Emerson E. Sharpe III
4  Department of Interventional Radiology, Kaiser Permanente, Denver, Colorado
Paul J. Rochon
5  Division of Vascular and Interventional Radiology, Department of Radiology, University of Colorado Anschutz Medical Campus, Aurora, Colorado
› Author Affiliations
Further Information

Publication History

Publication Date:
05 April 2018 (online)


Pelvic venous insufficiency is now a well-characterized etiology of pelvic congestion syndrome (PCS). The prevalence of CPP is 15% in females aged 18 to 50 years in the United States and up to 43.4% worldwide. In addition to individual physical, emotional, and quality-of-life implications of CPP, there are profound healthcare and socioeconomic expenses with estimated annual direct and indirect costs in the United States in excess of 39 billion dollars. PCS consists of clinical symptoms with concomitant anatomic and physiologic abnormalities originating in venous insufficiency. The etiology of PCS is diverse involving both mechanical and hormonal factors contributing to venous dilatation (>5 mm) and insufficiency. Factors affecting the diagnosis of PCS include variance of causes and clinical presentations of pelvic pain and relatively low sensitivity of noninvasive diagnostic imaging and laparoscopy to identify insufficiency compared with catheter venogram. A systematic review of the literature evaluating patient outcomes following percutaneous treatment of PCS is presented.